Shortly after being demobbed at the end of the second world war, Ian Douglas-Wilson was interviewed for a job at the BMJ. He was told by its editor, Hugh Clegg, that he was too radical for the then staid publication, and that he should apply for a job at the Lancet. Douglas-Wilson followed Clegg’s advice and was appointed assistant editor at the Lancet in 1946. He stayed with the journal for the next 30 years, the last 11 of which he served as editor.

Whether he could be described as a true radical or not is a moot point, but he certainly did not mind upsetting the establishment—medical or otherwise. In the 1960s, when GPs were threatening to withdraw their services over pay, he wrote an editorial criticising their stance. He also wrote in support of trainee psychiatrists, who had been given a platform in the journal to campaign for a fairer examination system.1 According to Robin Fox, one of Douglas-Wilson’s new recruits at the time, his support of the young psychiatrists was typical of his editorial campaigns: “Pungent, pro-young, and critical of elites (as exemplified here by the royal colleges).”

In 1968, when Europe was shaken by a series of violent student uprisings, he invited a student from Essex University to write about his rustication from the university.2 David Triesman (now a Labour peer) was a politics student, and his article had nothing to do with medicine, but Douglas-Wilson felt it important that the voice of the young be heard in the journal.

Douglas-Wilson’s editorship also saw the Lancet become increasingly international. He introduced a section dedicated to foreign news, and accepted more papers from overseas. In 1973, to mark the journal’s 150th anniversary, he published a book with the Nuffield Provincial Hospitals Trust entitled Health Service Prospects, a review of different health systems around the world.

His focus was practical too, and he introduced a faster selection and publication process. David Sharp, another assistant editor, remembers that when he joined the Lancet it was not accepting many submissions as Douglas-Wilson was keen to process the backlog of papers. The commissioning process then became very slick: papers were read by the journal staff and a small team of advisers, and were quickly accepted or rejected.

Douglas-Wilson did not agree with routine peer review, believing that for a general journal such as the Lancet, any controversy or inaccuracy could be dealt with in the correspondence pages. In 1977, after his retirement, he wrote a piece in the New England Journal of Medicine (NEJM) explaining his opposition. He stated that reviewers tended to be cautious and were “apt to be swayed by the current vogue in their discipline.”3

“The expert is as likely as not a member of an in-group, recoiling from utterances that do not blend readily with the group’s current thinking. If he delivers an adverse opinion of an article, the editor may pass it to a second adviser who adheres to the same or an allied group. The hapless author, having failed to carry either of two peers with him, may be asked to approach another journal, where a similar review process has the same outcome,” he wrote.

As the Lancet was by this point moving towards peer review, the article embarrassed his former colleagues and cost the journal some readers and authors.

The NEJM article showcases Douglas-Wilson’s pithy and elegant style, as well as being a manifesto for the kind of journal that he wanted to edit. “The general journal (in my view) may properly seek to be always fresh, often stimulating, sometimes provocative, occasionally funny—and correct if possible.”

Douglas-Wilson used to ask of a submitted paper “Does it have the ring of confidence?” He was, however, ready to admit when the journal had got things wrong. In 1972 he went to Northern Ireland to apologise in person to doctors who complained about an editorial that said hospitals were not “effectively under the control of the medical staff or the management committee” during the civil unrest.4

Douglas-Wilson was born in Harrogate, north Yorkshire, where his father was a spa doctor. He attended Marlborough College, and then, after a short time working for the John Player cigarette company, went to Edinburgh University to read medicine. He did house jobs in Edinburgh and then joined the Royal Army Medical Corps at the outbreak of war.

Politics were a constant presence in the family home, with the Douglas-Wilson family taking in two refugees after the Hungarian uprising in 1956. Douglas-Wilson’s daughter, Liz Huhne, remembers the family talking “non-stop” about the Suez crisis, with her father opposing the British government’s stance. He also went on one of the first Aldermaston marches in protest at nuclear armament.

Douglas-Wilson retired from the Lancet in 1976 to look after his wife, Betty, who had had a brain operation. At the same time he gave up writing, despite his family’s best efforts to convince him otherwise.

His wife died in 1999. He leaves two daughters and a son.

Notes

Cite this as:BMJ 2013;347:f7187

Footnotes

Ian Douglas-Wilson (b 1912; q University of Edinburgh 1936), died from heart failure on 15 October 2013.